Minimally invasive or keyhole, catheter based treatments for coronary artery disease have revolutionised the treatment of ischaemic heart disease. Now many patients even with narrowings in two or occasionally (in selected patients) all three of the coronary arteries, can be treated for angina, acute coronary syndrome or heart attack, by angioplasty.

The thin flexible tubes used for angiography can be used to pass tiny wires down through narrowings and blockages in coronary arteries. Balloons and other devices can then be passed over the wires to open up obstructed arteries, and in the majority of cases now, one or more stents are left behind to hold the artery open after initial balloon dilatation. These stents are expandable scaffolds which not only supply mechanical support to the artery, but also carry drugs to reduce the chance of recurrent narrowing of the treated segment of artery.

Dr Pegge performs coronary intervention in the dedicated cardiac catheter laboratories at Worthing Hospital and at Brighton and Sussex University Hospitals NHS Trust (the Royal Sussex County Hospital, Brighton).